Pneumologie 2020; 74(S 01): 83
DOI: 10.1055/s-0039-3403246
Freie Vorträge (FV12) – Sektion Klinische Pneumologie
Hot Topics der klinischen Pneumologie
Georg Thieme Verlag KG Stuttgart · New York

COPD characteristics and progression of patients with high vs. low health status: an analysis of the observational DACCORD study

H Worth
1   Facharztforum Fürth; Pneumologische Praxis Dr. Kellermann
,
CP Criée
2   Pneumologie, Beatmungsmedizin/Schlaflabor, Evangelisches Krankenhaus Göttingen-Weende; Department of Sleep and Respiratory Medicine, Evangelical Hospital Goettingen-Weende, Bovenden, Germany
,
P Kardos
3   Lungenpraxis Maingau
,
V Obermoser
4   Novartis Pharma GmbH
,
K Berschneider
4   Novartis Pharma GmbH
,
R Buhl
5   Med. Klinik III, Schwerpunkt Pneumologie, Universitätsmedizin Mainz
,
C Vogelmeier
6   Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Phillips-University Marburg, Germany, Member of the German Centre for Lung Research (Dzl)
› Author Affiliations
Further Information

Publication History

Publication Date:
28 February 2020 (online)

 
 

    Introduction: The COPD assessment test (CAT) total score is frequently used to quantify the symptom load of COPD patients. In the German non-interventional, prospective DACCORD study, COPD patients were followed over 2 years. Here, we compare the subgroups with a low (CAT < 10) vs. a high (CAT > 30) symptom burden at baseline.

    Methods: DACCORD recruited COPD patients who either initiated or changed COPD maintenance medication prior to study entry. During the follow-up period, CAT score and spirometry were evaluated annually with exacerbations and COPD medication captured every 3 months.

    Results: Out of 6611 patients with valid follow-up documentation, 735 patients had a CAT < 10 and 496 patients a CAT > 30 at baseline. Patients in the CAT > 30 group were more likely to be female (49.8% vs. 38.8%) and to have comorbidities (74.6% vs. 61.2% with at least one comorbidity). Patients with CAT > 30 had worse lung function at inclusion (FEV1% predicted: 53.8% vs. 66.0%) and had exacerbated more frequently in the 6 months before study entry (46.4% vs. 12.4%). During follow-up, exacerbation frequency remained low in the CAT < 10 group and decreased in the CAT > 30 group to 30.8% exacerbating patients in year 2. This is in accordance with changes in CAT score, which remained rather stable in patients with low CAT score while 80% of patients with CAT > 30 experienced a clinically meaningful improvement.

    Conclusion: In DACCORD, patients with a low CAT score remained relatively stable over a course of 2 years. Patients with a CAT > 30, however, showed an improvement in CAT total score and a reduction in the exacerbation rate during follow up, suggesting that this improvement is driven by the optimization of therapy going along with the initiation or change of medication at baseline.


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